The Children’s Place: Jenna Sandler’s Experience

As the non-clinical member of the team, I’ve gotten a slightly different perspective on Mongolia than the physicians. I’ve spent most mornings at the Children’s Place orphanage and then I’ve gone over to the hospital to hear the doctors’ lectures in the afternoons. The children at the orphanage were instantly affectionate and welcoming. Despite the language barrier, they somehow were able to communicate with me through pointing and gestures. We decorated t-shirts, played hide and seek, played outside, sang songs, did gymnastics, I braided hair, helped some children with math homework (luckily math is universal!) and we took lots of pictures.

It’s quite amazing to watch the older children take care of the younger ones. There is one girl with Autism and the older children also act as caregivers to her. There are 27 children at the orphanage ranging from ages 1-13. This little boy around 2 years old held onto my hand the whole time I was there:

Aside from my mornings at the orphanage, I spent the afternoons listening to the lectures by my dad, Dr. Gayle, and Dr. Abram. I also spent some of my time sitting in on patient encounters with my dad and Dr. Abram. One morning, I went with Dr. Abram to the developmental center (which is attached to the orphanage) where they provide therapy to children with developmental delays or conditions such as cerebral palsy and kernicterus. The center treats children from the countryside who would never otherwise have access to such services. The families travel very long distances to bring their children to the center and they often stay in Ulaanbaatar for the 2 week initial assessment and treatment. In addition to providing therapy (physical therapy, speech therapy, occupational therapy, etc), the providers teach the parents how to nurture their children’s development at home and sometimes actually provide equipment such as braces for children with cerebral palsy for the family to take home.

At the center, I spoke to a mother who has a child with Autism. The therapists at the Developmental Center are teaching him to communicate simple choices such as which food he would like to eat through the use of picture cards (he is completely non-verbal). His mother was very frustrated by the lack of services here in Mongolia and desperately wants to move to another country to find the best care for her son. I told her about Autism services in the United States and about other parents’ experiences with having a child diagnosed with Autism. She seemed very hopeful about her son’s future, saying that she read stories on the Internet about Autistic children becoming writers and doctors.

So far, my impression of medicine in Mongolia is that they are working diligently to improve their care but they are still a few decades behind. Very few of the physicians speak English and, as a result of language barriers and time, very few of them stay up to date with the latest research and recommendations. Many of their practices are outdated and ineffective, and many of the patients’ conditions are preventable. On the flip side, as I sat in on the patient encounters, I noticed that the parents knew every detail about their children’s medical history, including the dosage of all the medications. They asked a lot of questions and seemed very engaged during the visit. It’s also very apparent how much they respect and trust physicians. In this respect, Mongolia has far surpassed the United States.

Ryan

Grace

It’s hard to imagine how difficult tutoring must’ve been given language barrier, but it seems to have worked out in the end. Also, that little boy who held your hand is adorable. Thank you for sharing this piece.